Chaplaincy Consent Form

Chaplaincy Consent Form

Parental/Guardian Consentfor

Voluntary Student Participation in Chaplaincy Program at SandyStraitStateSchool

Parent/Guardian Name/s
Student Name (in full)
Student Name (in full)
Student Name (in full)

The SandyStraitStateSchool community provides a chaplaincy program endorsed by the school’s Parents and Citizens’ Association and available on a voluntary basis to all students.The chaplain is involved in a range of activities which happen at this school which are free of religious, spiritual and/or ethical content. These activities are available to all students on a voluntary basis unless a parent or guardian requests in writing that this is not to occur for their child/ren.

Chaplains may also be involved in activities with religious, spiritual and/or ethical content and additional consent is sought from parent/guardians for these specific activities.

Information about the school’s chaplaincy program is on the school’s website. Prior to commencement of any additional activities with religious, spiritual and/or ethical content in the school,parents/guardians will be advised through the school newsletter and website.

Voluntary Student Activities without Religious, Spiritual and/or Ethical Content
These activities are available to students on a voluntary basis if a parent or guardian has given consent in writing. / Voluntary Student Activities with Religious, Spiritual and/or Ethical Content
These activities are available to students on a voluntary basis if a parent or guardian has given consent in writing.
1. Lunch time play activities which may include: Organized sport, drama, board games, physical challenges, skipping.
2. Pastoral care – Assisting students with school related issues. / 1. Activities may include: One to one meetings with chaplain for religious and spiritual support.
2. Visiting performances e.g. Christian Bands, singing groups.
3. Pastoral Care- One on one/small groups discussions with students regarding presenting issues.
Please tick one of the boxes below:
□I give my consent for my child/ren to participate in these activities
□I do not give my consent for my child/ren to participate in these activities. / Please tick one of the boxes below:
□I give my consent for my child/ren to participate in these activities.
□I do not give my consent for my child/ren to participate in these activities.

□I understand that, where I agree that my child/ren can participate in the chaplaincy program, this information will be passed on to the school chaplain.

Parent’s Signature ______Date ______

Office Use:
Retain original in student’s file and provide a copy of notice to the parent/guardian.